Inadequacies of repeated radiological examinations in a University Hospital

Purpose: To establish why 16% of 1,045 patients undergoing abdominal and/or vascular surgery referred to the University Department of Radiology for a B-image sonogram reported that a US of the same regions of the body had bee n conducted during the previous 6 weeks without any changes in the clinical status. Statement of the problem: Evaluation of the reasons for these superfluous e xaminations and analysis of the consequences that the US follow-up examinat ions implied for the patient. Material and Methods: One senior resident radiologist and one senior reside nt surgeon reviewed the medical records of the patients reporting previous examinations and examinations scheduled at the time of the questioning of t he patients. Results: One hundred and eight (63%) of the 171 medical records were availa ble. Data on previous examinations mentioned in the report forms were incor rect in 14 cases (13%). Therefore, further evaluations were based on 94 pat ients. Ten (8%) out of 121 sonograms, 4 (10%) out of 40 CT and 2 (20%) out of 10 MR investigations documented in the medical records had not been ment ioned by the patients. As many as 41 (75%) of the 55 preliminary sonograms performed by general practitioners and specialists in private practice were not documented in the medical records. Even though records existed of clin ically plausible findings, 36 (84%) of the 43 preliminary US investigations performed by doctors in the University Hospital were repeated to verify th e diagnosis without any further diagnostic benefit. Conclusion: A cross-speciality consensus over the diagnostic value of B-ima ge sonography and management of the findings obtained is of paramount impor tance.